About the role
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Follow up with insurance companies on outstanding and unpaid claims via calls or payer portals.
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Analyze and resolve denied, rejected, or underpaid claims by identifying root causes and taking corrective actions.
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Initiate and track appeals and claim resubmissions to ensure maximum reimbursement.
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Review aging reports and prioritize accounts to reduce AR days and improve collections.
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Maintain accurate documentation of calls, claim status, and actions in billing systems.
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Coordinate with billing, coding, and internal teams to resolve discrepancies and correct claim errors.
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Verify insurance eligibility, benefits, and coverage details when required.
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Communicate effectively with insurance representatives to negotiate payments and resolve issues.
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Ensure compliance with healthcare regulations and payer guidelines during claim follow-ups.
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Meet daily productivity targets, including call volumes and collection goals.
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Identify trends in denials and provide process improvement suggestions to enhance billing efficiency.